After you’ve downloaded the form below and opened it in Acrobat Reader, you can either fill it in with your computer and print it, or you can print it and then fill it in by hand. If you choose to complete it by hand, please clearly print all information on this form. Be as accurate as possible when completing the form, since this information is used to maintain your membership records along with your membership certificate and membership identification card. Current members need not complete the membership application section.




If e-mailing this form to ILEETA at, please re-name the file using your conference badge name and” 2015crf”. For example: John_A_Smith_2015crf. If you e-mail your registration you will receive a confirmation reply within 3 business days.


8150 White Oak Ave.
Munster, IN 46321


Call ILEETA at 262-767-1406 OR email